Aims: To assess the changes in vascular surgical practice over a decade and its implications for higher surgical training. Methods: Between 1992 and 2001, data for all arterial operations performed under a single vascular surgeon were entered consecutively into a computerized database. The number of vascular index procedures performed per annum was calculated. The index procedures used were: abdominal aortic aneurysm repair, carotid endarterectomy and infrapopliteal reconstruction. Results: The median number of arterial procedures performed per annum was 238 (range 208–304). Over the decade, there was a steady increase in abdominal aortic aneurysm (AAA) surgery from 53 cases (25 per cent of total arterial workload) in 1992 to 81 cases (33 per cent) in 2001. This was similar for carotid surgery, which increased from 24 cases (11 per cent) in 1992 to 54 cases (22 per cent) in 2001. Higher surgical trainees performed an average of 22 AAA repairs and 15 carotid endarterectomies per annum. In contrast, infrapopliteal reconstruction decreased from 30 cases (14 per cent) in 1992 to 6 cases (2.4 per cent) in 2001. This change in practice has been particularly noticeable in the last 2 years when higher surgical trainees have only performed an average of two infrapopliteal bypasses per annum. Conclusion: The changes in vascular surgical practice may mean that higher surgical trainees will not receive adequate exposure to infrapopliteal bypass with the current length of training. [ABSTRACT FROM AUTHOR]